By Lawrence M Spindel DDS Friday April 6, 2007

There are  three ways to replace missing teeth; implant supported crowns, fixed bridgework restotations or removable denture prosthesis.  All  tooth replacements that dentists fabricate for patients fall into or combine aspects of these three replacement categories.  This article will describe each method of tooth replacement and may help understanding them.

Implant supported crowns: Assuming the patient has the proper boney support and no health contraindications this is probably the best option.  A titanium insert is  inserted into the bone where a tooth is missing and 4-6 months later a restorative dentist usually places an a abutement(post) and a crown .  If multiple teeth are missing than if conditions allow , multiple implants are placed and after 4-6 months a fixed bridge or over denture is inserted . Since implant restorations don’t depend on adjacent natural teeth for support, no involvement of adjacent teeth is required.

Fixed bridge restorations: For most patients this is the second most desirable tooth replacement, especially if  the number of teeth being replaced is small.  This choice is the best for patients without sufficient bone to support an implant and for those who have health conditions which may make implant placement undesirable(smokers, diabetics, immunocompromised patients are just a few examples).  This is also a desirable option if the space is small and the adjacent teeth already have crowns or may require crowning in the near future.

Removable dentures: This is probably the most prevelant way to replace missing teeth around the world.  It can be the most affordable way to replace teeth especially when more than one tooth is missing. Dentures can be full (replacing all teeth in one of the jaws or partial (replacing teeth in a partially edentulous jaw).  Although many patients around the world do fine with their dentures, they do have drawbacks.  Food tends to collect around the denture when a patient eats , often requiring its removal after a meal.  Also, it is recommended that dentures  be removed at night so that a patients’ mouth doesn’t become irritated.  Often dentures don’t “feel” like natural teeth do when chewing food since many dentures, at least in part, are supported by a  patient’s gums.

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Other relevent article links:

“To Save (a tooth) or not?”

“Bone Regeneration”